The inner object

The Lancet has a wonderful article on how medicine has understood how strange objects have ended up in the body and how this has influenced our understanding of the body and behaviour.

The piece notes that cases where people have swallowed or inserted foreign bodies into themselves have been important for surgery and even anatomy – hair swallowers apparently provided useful “hair casts of the stomach”.

However, it is no surprise that interest turned to understanding why some people put objects into themselves.

Thus, in surgical writings, the foreign body became something from which psychological meaning could be drawn. In 1913, William Clayton-Green puzzled: “Did hair-swallowers desire to do something which others abhorred? Or did they wish to excite wonder and interest and to puzzle their doctors? Or was hair-swallowing a form of psychical tic, occurring in mentally abnormal subjects?” He and his contemporaries struggled to answer such questions. This new interest in a psychological model of the foreign body is also apparent in the case of a young woman, Beatrice A, admitted repeatedly to the Royal London Hospital between 1898 and 1909 for the removal of hairpins inserted into her bladder. On her first admission, the young milliner was described as “[m]ad as a hatter”.

Yet, by 1909, this conclusion did not seem so obvious. Beatrice’s actions were now referred to as a “habit”, and it was noted that no other symptoms of insanity had been observed. Beatrice herself informed the surgeon “that she formerly suffered from an impulse to throw herself out [of] windows [and] once did it. Many years ago however she gave this up for the now harmless amusement of putting hairpins into her bladder.” This unusual explanation appears to have perturbed Beatrice’s surgeons, located as it was somewhere between the rational and the irrational: inserting hairpins did indeed seem less dangerous than falling from a height, but why might she need to do either? Thus articles in the next few decades debated the psychological meaning of foreign bodies, with a wide array of possible explanations suggested from hysteria to malingering, sexual perversion, and “professional swallowing”.

The image is of objects found in the stomach of a “26-year-old woman who was admitted to hospital in 1915, having accidentally swallowed a metal hook 2 weeks previously, since when there had been pain and the vomiting of black material”.